Job responsibilities
Job Purpose:The Diabetes Specialist Nurse (DSN) will be an experienced registrant who is capable of providing highly complex advice on specialist care within the Somerset Primary Care Networks (PCNs) and Neighbourhoods. There is an expectation to support a county wide model of service whilst holding a caseload within a locality.
The post holder will support development of management plans for patients with urgent complex diabetes issues, liaising with relevant members of the multidisciplinary team (MDT). This is with the aim and expectation of reduction in need of acute admission and reduction in length of acute admission, where clinically safe. The post holder will ensure correct patient pathways are followed, allowing and encouraging a seamless interface between primary and secondary care. Lead specialist for defined geographical locality, Non Medical prescriber practicing within the Prescribing Competency Framework, Mentor and develop Band 6 DSNs, Participate and contribute to the development of the Somerset diabetes service and operational deliver of care, To participate actively in regular virtual complex care meetings to support colleagues with highly complex diabetes queries or issues, To participate actively in regular MDT within the PCN and neighbourhoods to support wider colleagues with highly complex diabetes queries or issues and capable of professional challenge to ensure best patient care and outcomes. Duties and Responsibilities: Communication and Key Working Relationships. To provide and receive complex, sensitive contentious information where highly developed interpersonal and communication skills are essential.Communicate with patients, colleagues, and stakeholders, across acute and primary care services, internal and external contacts in a courteous, professional, and timely manner i.e., telephone, written, face to face or virtual consultation. Provide specialist, tailored diabetes nursing advice and support to patients, families carers throughout their diagnosis. Receive highly complex and sensitive or contentious information which require tact or persuasion where cooperation is required on decision-making. Develop and maintain effective working relationships with relevant colleagues and teams to enable and uphold best patient care. Develop, maintain, and improve links with primary and secondary care colleagues, providing expert specialist advice regarding diabetes referrals.Participate in virtual clinics across the PCN and neighbourhoods regular, providing highly specialist diabetes advice.Participate in or lead on education forums locally.
Planning and Organisation. To prioritise and manage own workload acting as an independent practitioner within scope of competency.Provide seamless service delivery to people requiring further diabetes support upon acute discharge, working cohesively with acute facing teams. Receive hospital discharge referrals to help prevent hospital re-admission, this will require regular contact with secondary care providers. As part of the diabetes development across Somerset, attend, lead and provide highly specialist knowledge within virtual clinics across GP surgeries within PCN. Identify educational requirements across PCN and Neighbourhoods. Support other Somerset localities as service requires. Contribute on service redesign, reviews, strategic planning, and changes to practice ensuring integrated working with other services. Deputise for Lead DSN as required.
3 Analytics. Use analytical, highly specialist skills and knowledge to assess and plan patient care, ensuring time effective interpretation and action of results. The post holder will be an independent prescriber. To provide complex specialist advice for Advice and Guidance (A&G), providing a triage service, responding to urgent issues that may otherwise necessitate to acute admission. Hold a wide knowledge of all types of diabetes therapies, including the wider cardiovascular risk (renal management, lipid management) and capable to professionally challenge where necessary to ensure best patient care. Undertake specialist assessments. Plan, implement and evaluate treatment interventions in people presenting with multiple comorbidities. In response to A&G, provide clear and concise assessment reports to the referrer, outlining evidence base for comprehensive treatment recommendation. Provide primary care with optimal search criteria to enable focussed virtual clinic interventions. To recognise training and development needs of non-specialist staff across primary and secondary care and engage in supporting these needs. Provide highly specialist skills and knowledge when interpreting specific diagnostic results, including interpretation of the Ambulatory Glucose Profile (AGP). May be required to support with complaints when necessary. Responsibility for Patient / Client Care, Treatment & Therapy. Demonstrate awareness of potential unconscious bias towards individuals and promote equity of service to all.
Using highly specialist knowledge and skills, support patients and carers in the decision-making process with regard to treatment or lifestyle options for optimal diabetes care. Demonstrate highly specialist knowledge of all diabetes therapy groups and the implications for those with multiple comorbidities. Promote the upskilling of knowledge and confidence to other primary care colleagues during the virtual clinics within the primary care network and neighbourhood. Within the primary care networks, utilise highly specialist knowledge and skills to deliver group education sessions for medication starts, enabling whenever possible, the local teams to continue this education.Prescribe medication for therapeutic effectiveness, appropriate to patient needs and in accordance with evidence-based practice, national and local protocols, and within scope of practice.
4 Policy, Service, Research & Development Responsibility To work within policy, professional and legal frameworks at all times. This requires knowledge of NMC Code of Professional Conduct, Non-Medical Prescribing Framework. Working closely with the Nurse Consultant clinical lead and DSN lead to support and promote the service delivery plan and priorities. With the Nurse Consultant and DSN lead, take an active role in service redesign where appropriate to ensure the continuation of an evolving, high-quality, diabetes service. Work closely with the Diabetes team lead to promote both team cohesion and positive working environment. To work as part of the wider Diabetes MDT towards a shared goal of service improvement and best practice. When requested, deputise for the Team Lead at countywide diabetes programme board meetings. Undertakes staff surveys or audits necessary to own work. Participates in research and development as and when work stream requires. Demonstrate highly specialist knowledge when translating research findings into clinical practice. Use highly specialist knowledge to promote a culture of evidence-based practice within the team, demonstrating a wider expert knowledge relating to research and practice within the diabetes speciality. Follows Trust policies and in own role and participate in the development of new, or updating of, policies and standard operating procedures as required. Work in line with The TREND Integrated Care and Competency Framework for Adult Diabetes Nursing to Senior Practitioner or Expert Nurse level. Responsibility for Finance, Equipment & Other Resources. Support the clinical environment in meeting cost savings targets by driving efficiency in the service and making best and most appropriate use of resources. Responsible for ensuring that equipment is appropriately used, stored, and maintained. Responsibility for Supervision, Leadership & Management Provide supervision and training to pre and post graduate individuals. Using highly specialist skills and knowledge to support, mentor and train new team members and current Band 6 DSNs.5 Participate in appraisal and clinical supervision as required. Continually update and maintain own self-development and awareness, identifying and utilising appropriate educational and study resources. Participate in Trust mandatory training. Information Resources & Administrative Duties. Have a comprehensive understanding of Trust information systems/speciality systems. Have sound IT skills, including Microsoft Office and Outlook, entering data onto electronic patient records. Trust Incident Reporting system. Ensure accurate and timely recording of all workload activity via patient information systems to inform analysis of service delivery and continued service development. Maintain specialised databases including input, updating and retrieval of statistics. Contribute to the compilation of reports regarding the service reports if required. Use highly specialist knowledge to support primary care in the identification of specific patient groups, through practice searches, in preparation for virtual clinics. Any Other Specific Tasks Required. Ability to work flexibly and to be able to travel to other areas as and when required. Ability to work under pressure and flexibly according to clinical challenges or unexpected changes in workload. Willingness to develop further leadership skills including Trust management essential learning.
